Kong Weiming, Liang Shikai, Lv Xianli
Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Litang Road 168, Beijing, 102218, China.
Neuroradiology. 2025 Feb;67(2):415-421. doi: 10.1007/s00234-024-03541-6. Epub 2025 Jan 20.
Since the emergence of the Pipeline Embolization Device (PED), its off-label use has significantly improved the treatment effectiveness of complex intracranial aneurysms, including the treatment of recurrent aneurysms. Although PED is effective in this situation, there is still a lack of evidence-based medicine for its role in recurrent aneurysms after stent-assisted coiling. The aim of this study is to evaluate the safety and efficacy of PED treatment for recurrent aneurysms after stent-assisted coiling.
This study included 10 patients who underwent stent-assisted coiling but subsequently received PED treatment again due to aneurysm recurrence or rebleeding. The mean time between initial treatment and subsequent treatment is 12 months. Clinical outcomes include complications and modified Rankin Scale (mRS) scores, as well as evidence of complete occlusion.
All PEDs were successfully placed, with one case of minor perioperative complications. During the 6-month follow-up after PED implantation, 10 cases of recurrent aneurysms were completely occluded without any adverse clinical sequelae. In one case of vertebral artery aneurysm, balloon dilation was performed before placing PED due to arterial stenosis proximal to the aneurysm.
The use of PED to treat recurrent aneurysms after stent-assisted coiling is a safe and effective treatment method.
自Pipeline栓塞装置（PED）出现以来，其非标签使用显著提高了复杂颅内动脉瘤的治疗效果，包括复发性动脉瘤的治疗。尽管PED在这种情况下有效，但对于其在支架辅助弹簧圈栓塞术后复发性动脉瘤中的作用仍缺乏循证医学依据。本研究的目的是评估PED治疗支架辅助弹簧圈栓塞术后复发性动脉瘤的安全性和有效性。
本研究纳入了10例接受支架辅助弹簧圈栓塞但随后因动脉瘤复发或再出血而再次接受PED治疗的患者。初次治疗与后续治疗之间的平均时间为12个月。临床结果包括并发症、改良Rankin量表（mRS）评分以及完全闭塞的证据。
所有PED均成功置入，围手术期有1例轻微并发症。在PED植入后的6个月随访期间，10例复发性动脉瘤完全闭塞，无任何不良临床后遗症。在1例椎动脉动脉瘤中，由于动脉瘤近端动脉狭窄，在置入PED前进行了球囊扩张。
使用PED治疗支架辅助弹簧圈栓塞术后的复发性动脉瘤是一种安全有效的治疗方法。
